The DOI matches its Crossref record; 112 of the 114 references it cites were found in a registry or an index.
How accurate is pulse rate variability as an estimate of heart rate variability?
Abstract
Background The usefulness of heart rate variability (HRV) as a clinical research and diagnostic tool has been verified in numerous studies. The gold standard technique comprises analyzing time series of RR intervals from an electrocardiographic signal. However, some authors have used pulse cycle intervals instead of RR intervals, as they can be determined from a pulse wave (e.g. a photoplethysmographic) signal. This option is often called pulse rate variability (PRV), and utilizing it could expand the serviceability of pulse oximeters or simplify ambulatory monitoring of HRV.Methods We review studies investigating the accuracy of PRV as an estimate of HRV, regardless of the underlying technology (photoplethysmography, continuous blood pressure monitoring or Finapresi, impedance plethysmography).Results/conclusions Results speak in favor of sufficient accuracy when subjects are at rest, although many studies suggest that short-term variability is somewhat overestimated by PRV, which reflects coupling effects between respiration and the cardiovascular system. Physical activity and some mental stressors seem to impair the agreement of PRV and HRV, often to an inacceptable extent. Findings regarding the position of the sensor or the detection algorithm are not conclusive. Generally, quantitative conclusions are impeded by the fact that results of different studies are mostly incommensurable due to diverse experimental settings and/or methods of analysis.
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“A comparative review of photoplethysmography against ECG stated that photoplethysmography can be used during rest but not during stress (Schafer and Vagedes, 2013).”
From Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research – Recommendations for Experiment Planning, Data Analysis, and Data Reporting (2017) · cites this paper as Schafer and Vagedes, 2013
In the citing paper
“However, it cannot yet be considered to be a surrogate during exercise or stress [17], [129].”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [17]
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“Nonetheless, reviews have concluded that PRV is a good surrogate of HRV for certain applications at rest.”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [17]
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Metadata
- Authors
- Schäfer, A., & Vagedes, J.
- Affiliations
- Academic Research in Complementary and Integrative Medicine (DE)
- University Children's Hospital Tübingen (DE)
- Corresponding author
- Vagedes, Jan
- ORCID
- Vagedes, Jan
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 166
- Issue
- 1
- Pages
- 15-29
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W188715143
- Cited by
- 661
- References
- 114
- Citations by year
- 2026: 59 · 2025: 51 · 2024: 56 · 2023: 52 · 2022: 57 · 2021: 72 · 2020: 67 · 2019: 49 · 2018: 59 · 2017: 40 · 2016: 40 · 2015: 29 · 2014: 19 · 2013: 9
- FWCI
- 11.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- pulse rate variability, heart rate variability, photoplethysmography, pulse oximetry, RR interval, measurement accuracy, physical activity, psychological stress, sensor position, detection algorithm, ambulatory monitoring
- MeSH terms
- Electrocardiography, Heart Rate, Humans, Motor Activity, Pulse, Rest, Photoplethysmography
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